The primary objective of this proposal is to identify variables related to the outcome of nursing home care. Using a random sample of patients in a random sample of 80 nursing homes in Ohio and Washington, data on patient mental and physical status and satisfaction of patients with services will be collected over a three-year period of time. Staffing patterns, costs, employee and administrator attitudes, environmental and structural variables and ownership-control status, among other variables, will be considered for relationship to outcome measures of nursing home care. Data collected and relationships examined will aid in the evaluation of quality of care and in the assessment of the different regulations and reimbursement patterns on the outcome of nursing home care.